NEDA Week 2014: Thoughts on Body Dysmorphia

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NEDA Week 2014: Thoughts on Body Dysmorphia

NEDA week is officially over, as of yesterday, but I’m going to extend the theme for one more day (and share weekend reading tomorrow) so that I can delve into a topic that a few readers have asked me about in the last six days: body dysmorphia. (Between this and orthorexia, I’m diving into a lot of the tough stuff this week!)

I should start by saying that I don’t have anything to say about this topic that resembles an “answer,” or even a resolved thought. I can only share what I’ve experienced and what I’ve learned along the way. If you’re suffering from any degree of serious body dysmorphic disorder (defined as “excessive concern about and preoccupation with a perceived defect of their physical appearance,” but if you’re in the thick of it, you’ll probably know), then I urge you to talk to a professional. This particular struggle can feel incredibly permanent and unchanging. But a therapist or another health care provider may be able to lead you toward a breakthrough.

Without wanting to minimize the condition, I’d wager that a large number of people suffer from some degree of body dysmorphia. How many friends do you have who seem unable to regard their bodies with objectivity? Who say that they’re “fat,” and seem genuinely to believe it, when it isn’t accurate? Statements like these are so commonplace that it’s tempting to roll ones eyes, shrug them off, or chuckle. And the truth is that it’s fashionable enough to dislike one’s own body that an offhand remark or two might not actually indicate anything serious. But beneath it all, there may be lurking a deep well of self-loathing, a battle between body and mind. One of the things I cringe most to remember about my teenage and college years was how often I declared myself fat or ugly around my friends and peers. Looking back now, I’m amazed that my friends tolerated it all so patiently. But maybe they saw they something I couldn’t see at the time, which was that those comments were my attempt, however childish or irritating, to verbalize something I really did feel: a relentless loathing of the body I inhabited.

It’s hard for me to remember any time of my life in which I didn’t feel this way. From a very early age–8, 9, or 10, maybe–I started to feel that there was something monstrous about my physical person. I felt big, ungainly, awkward. I dreamt of slicing away slabs of my own flesh, winnowing myself down to something lean and sinewy. It’s hard to pinpoint what made me feel this way; I went to an all girls’ school, and it was certainly not an easy environment as far as body image goes, but I was never the object of excessive teasing. My mother has a fantastic relationship with food and set a good example. Yet there was always a suspicion, a deep and persistent fear, that there was something wrong with my body, something unruly, some deep and uncontrolled appetite lurking within.

The dysmorphia abated to some extent once my ED began in earnest, and it was diminished during my relapses as well. Maybe this is because the disorder itself gave me with the illusory sense of “control” over my physical form that I so desperately craved, a sick kind of dominion of mind over body. Maybe it’s because all of the routines and habits and calculations left little space for body preoccupation. Maybe–sadly–it’s because I usually liked what I saw in the mirror during those periods. It was as if, for the first time, I could see some of the positive attributes that people around me had seen all along. Part of my fear of recovery was the certainty that dissatisfaction and warped perception would once again become part of my everyday life.

Which they did, of course. During my final recovery–the one that lasted–they were particularly acute. I was gaining weight steadily, and I’d wake up each morning feeling trapped in a body that didn’t seem to belong to me. Sometimes, as I was pulling up a pair of jeans or staring in the mirror, I’d feel as if my skin was crawling. Needless to say, my pride in a certain kind of physical fragility had become a constitutive part of my identity, and I was struggling to find a sense of self without it. But I was also engaged in a very direct physical struggle, that old, familiar sense that the body I inhabited just wasn’t where I belonged.

It’s sad and embarrassing to look back upon all of this. But here’s the hopeful part: things got so much better. I never used to believe I’d be at peace with my body unless I was starving. But here I am, 31 and, if not always at peace with my body, I am at least committed being in a loving relationship with it. As I’ve mentioned in the past, my idea of “loving” my body doesn’t match up with the kind of unbridled enthusiasm and confidence you read about in magazines. I don’t enjoy trying on bikinis, or catch a glimpse of myself in spandex at the gym and relish what I see. I don’t even own a full length mirror. But there is so much that I love and take pride in.

To begin, my body is now healthy, energetic, and strong. My body has been better to me than I have been to it, and I am profoundly grateful. Working in hospitals and physician’s offices for the last two years has given me a new appreciation of health, and how precious it is–something I lost sight of frequently when I was busy cycling in and out of self-destruction.

Second, my body allows me to experience the world. It lets me touch and taste my way through life. It lets me enjoy delicious food, savor my first sip of hot coffee in the morning, run my fingers through sand and savor the feeling of wind on my face. It allows me to marvel at a Mozart concerto or feel exhilarated by one of my favorite mashups. It let’s me fling my arms around friends each time I greet them or move through sun salutations in yoga. For all of the mind/body disconnect that emerged from my ED, I’m a sensual person, and I thank my lucky stars for the body that helps me to connect with physical experience.

Lastly, I’ve gained a capacity to recognize my body’s beauty. Again, this doesn’t mean that I love what I see every time I glance in the mirror (who does?). It means that at least once each day, there is a moment or an experience that makes me feel beautiful. Maybe it’s when I’m arching into a backbend in yoga. Maybe it’s when I’m taking a brisk autumn walk through Central Park, so elated with the season and the place that I have to fight the urge to run. Maybe it’s the first few moments of a live show, when my toe starts to tap and I lift my arms in gleeful recognition of the opening song. Maybe it’s dancing with friends. Maybe it’s sex. These moments reveal my body’s beauty to me, not via a selfie or a “progress shot” or a number on a scale. They show me that my body can be a gateway to something wonderful. I can’t think of anything more beautiful than that.

I like to end these emotional posts with some practical, down-to-earth advice. While I don’t doubt that every experience of body dysmorphia or injured self-esteem is highly unique, I hope that these tips may help you to manage the day-to-day realities of coping with it.

1. Do activities that make you feel good. This can anything–walking, singing, dancing, painting, running, yoga, live performance. It could be rebounding or cooking or playing music. In my experience, physical satisfaction and enjoyment is a tremendous balm to the anxiety of body dysmorphia.

2. Wear clothes that make you feel good. I’ve said it before and I’ll say it again: if an article of clothing is going to make you feel badly, it’s not worth keeping around. For a very long time, I resisted donating pants and shirts that were so tiny I’d had no business wearing them in the first place, even though they did nothing but remind me of a body I no longer possessed. Letting them go was the right decision. If you’re midway through recovery, or you’ve passed through it but are still hanging onto garments that remind you of the old days, I really do urge you to allow your wardrobe to adapt.

3. Accept that your visual perception may lack objectivity. We’re all told that what we see in the mirror is not what others see, but it’s amazing how hard it is to accept this as a fact. It took me over thirteen years of disordered eating and recovery to realize that I simply don’t observe myself in the same way that others do. I can’t necessarily adjust my vision to fit “reality,” whatever that is, but I can choose to be conscious of the disconnect.

4. Be mindful of your words. Remember those self-deprecating comments I mentioned at the start of this post? These kinds of unkind words (or deeds–like my old habit of looking in the mirror and rolling my eyes) really are a form of self-harm. To this day I accept compliments uncomfortably, and I rely on self-depracation a little too much. But I’m trying to practice ahimsa with my words, just as I aim to practice it with my deeds.

5. Body acceptance isn’t about perfection or mastery. I wrote about this topic last year in two posts, both of which are worth checking out if you’re curious (here and here). But here’s the upshot: eating disorders present us with enough self-loathing, guilt, and shame. The last think you need is to feel additional guilt when you go through recovery and find that you don’t love your body all the time, from every angle.

Just as your diet and life don’t have to be “neat” and perfect and ordered, your relationship with your body does not have to be neat and perfect and ordered. It can be messy, difficult, and complex. It can have ups and downs. It can feel like work. What matters is that you don’t turn away from the work, and that you establish routines that help you to treat your body with self-respect. For me, these include giving my body nourishing foods, savoring their taste, moving mindfully, prioritizing healthy habits without feeling enslaved by them, and laughing often.

Three days ago, I met up with an old friend here on the West Coast, a photographer who snapped a few new photos of me to use for my blog. He hadn’t seen me in a long time, and mentioned how pleased he was to see that I’d “filled out”–a comment that was meant as a compliment, as well as an expression of relief that I’m healthy now. But…well, you know how it goes. Normally, a day like this–scrolling through images of myself, my friend’s remark, my painful awareness of how much my body has changed since my last relapse–would be triggering. Instead of dwelling on it all, though, I decided to be grateful that what people see when they look at me is no longer someone who’s struggling. I decided to accept the compliment for what it was. I decided to move on.

This photo was taken yesterday, here in Monterey, where I’m staying with my friend Christina. In the past, no matter where I was or how beautiful my surroundings, I’d skip taking so much as a single photograph of myself. This time, uncharacteristically, I asked Christina to catch something on my phone. I wanted to remember the feeling of the sun on my arms, the wind whipping my hair around, my very evident happiness at having spent the day with one of my best friends. I wanted to remember feeling healthy, and vibrant, and alive.

Maybe I’ll always have a complicated relationship with my body, as so many of us do. Maybe I’ll always feel ashamed of the fact that, for a time, I felt such comfort in a body that was so unwell. But I can appreciate progress. I can appreciate the fact that I’m more at peace with my body today than I am at odds with it. I can take pride in the fact that, no matter how I feel about my body, I don’t act on impulses to restrict, to limit, or deny. I can be thankful for the fact that, when I look at the photo above, I see the sun, strength, and contentment–all of the things I wanted Christina to capture–rather than flaws. It’s a step, a big one, and from where I stand tonight, it’s all pretty great.

I hope you guys took some good stuff away from these NEDA week posts, and of course I hope that awareness around these issues won’t stop tonight, tomorrow, or the next day. I’ve gotten a lot of emails from readers in the last few days, and if you’re thinking about reaching out, I encourage you to do so, or (more importantly) to check out further resources. And as usual, I look forward to hearing your thoughts.

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32 Responses to "NEDA Week 2014: Thoughts on Body Dysmorphia"

Hi Gena, your way with words always brings me to tears. And as you know, this is a topic with which I’m intimately familiar. My own experience with BDD is one of unfathomable preoccupation: truly, not five minutes goes by in which I am not thinking about my body, how others perceive my physical person. It’s hard to research at work, listen to friends, and be intimate because there’s an ever-present niggling self-loathing in the back of my mind.

Your description of walking through Central Park was particularly painful for me. When I visited the city this summer, we had a nice brunch at Blossom and, before leaving, I went to use the bathroom. Upon looking at myself in the mirror, I was horrified by my face: I perceived myself to be chubby and bloated. As soon as we left the restaurant, I burst into tears. I couldn’t help it. BDD is such a paralyzing condition, and when one is struck by a particular feeling of inadequacy, the whole world comes crashing down. Anyway, we walked over to Central Park and I sobbed on a bench, tired of myself and fully acknowledging that my understanding of my body was completely irrational to my then-boyfriend. Even though things have probably escalated since that day, I will always remember it as a point of realization that I couldn’t sit contentedly with this obsession.

Most of all, I’m distraught when I recognize the limiting capacity of BDD. With the cyclical nature of the obsession, I feel as though I can’t enjoy or benefit from life’s experiences. I think I’d probably be a lot more cultured, a better writer, and a more loving friend girlfriend, sister, and daughter if I didn’t have this all-encompassing concern. Sure, I visit museums, write as well as I know how, and try to involve myself in other’s lives, but it’s all done with a certain degree of detachment that only sufferers of BDD can understand. You describe a connection to things like yoga, autumn walks, live music, dancing, and sex; I’ve tried to experience all of these things, but BDD has another itinerary, one which I prioritize by default.

As always, you give me hope that some day I might come out on the other side. Thank you so much for addressing this particular issue. XO

What a beautiful, thought-provoquing post Gena. I don’t suffer from an eating disorder per se, but I have had 3 babies so I am not unfamiliar with the concept of trying to love a body that is less than perfect (to me). When I’m feeling blah about my body, it’ almost always about my midsection, I try to remember the 3 wonderful little people that I grew in there. I would not trade them for the most toned, flat, perfect belly in the world. As you mention in your post, when we focus on what our body allows us to do and feel rather than the details of how it looks, that is when it’s true beauty emerges.
What you wrote about being in pictures especially rang true for me. I’m always taking pictures of my kids but rarely are in them myself. I’ve appointed myself the photographer to avoid being in pictures. When my daughter commented on this (she’s 8) I knew something had to change. I now make an effort to ask others to take pictures of me. Sometimes I let one of my older two take the picture, which they love I love that I’m stating a good example : that being in the picture isn’t about looking perfect. It’s about having fun and remembering the special moment the picture was taken.

Beautiful post, Gena! I just wanted to comment that I am a reader of yours who does not have a history with an ED but I absolutely love these posts as they raise awareness of an issue I am not personally familiar with. Maybe my interest stems from my studies in dietetics and public health, but I’d venture to say that these posts really do appeal to a broad audience. Your writing is captivating and I look forward to reading your thoughts on these things so much, so thank you.

Moreover, most of us that are reading “healthy living blogs” probably have SOME experience with body dissatisfaction, balancing body image and health issues, maybe histories of diets and over-exercising, binge-eating and guilt, etc. It’s really a broad spectrum and I think MOST women at least dabble from time to time in some of the outright struggles of those with EDs, even if they are lucky enough to not fall into full-on disorder. These topics are important to all of us. Thanks for giving me so much to think about this week.

Thank you so much for this post, Gena. It truly is a gift to read your thoughts on and experience with issues like BDD, orthorexia, and eating disorders in general. You are a beautiful writer and I really do look forward to reading your blog.

I could wholeheartedly relate to the feelings you express having as a child regarding your body. As far back as I can remember, I felt so completely and utterly repulsed by my body, by all of the fat I saw in the mirror (of which there really never was). I was horrified at the shape of my body and from such a young age (around 8 like you) fantasized about cutting out all of my excess fat. Looking back, I was NEVER overweight; in fact, I was a thin child. It was terrifying for my parents to hear my dramatic concerns with my body and the self-hatred I had. Also like you, I can relate to being a bit confused about where the distorted body image came from. Unlike others, I was never criticized for my weight or the shape of my body as a young child. There was truly nothing to criticize as I was of normal weight and shape for a young boy.

I’m sure it’s hard for many to believe that men and boys are having issues like this, but BDD is a disorder that does not discriminate. In my case, it had nothing to do with the media or societal expectations or pressures to look a certain way. I was 8!

When it comes to living with BDD, you are so right when you talk about awareness being key. Knowing that your perception is “off” and that making decisions based on those skewed perceptions is a BAD idea is paramount in living a happy and healthy life.

Thanks so much again for this beautiful and so articulately written post!

Thank you Gena, for so much to think about. A few things stood out for me in this post… ‘2. Wear clothes that make you feel good’. I admit that I struggle with this right now. I have spent the last year taking control of my health on a deeper level, most notably healing my digestive system and balancing my hormones. It’s still a work in progress, but my body is certainly changing. I am holding on to some things (clothing for the most part) that no longer serve me. I have some work to do!

The second thing that stood out for me is, ‘appreciating the progress’. My body has been through so much and I am incredibly grateful for the strength and beauty in all of what I have been through. It’s time to focus on the rebuilding and acceptance of who I am, and allow my body to reflect the health I have worked so hard for.

Thank you Gena. I relate to pretty much everything you’ve written and though I’m probably not at your level of body acceptance yet I’m working on it and the good days are now more frequent than the bad.
Your advice is all very sensible. I’ve always been very sensitive to touch and how clothes feel so getting rid of clothes which don’t fit anymore has been really helpful for my recovery, as hard as it was to do.

Thank you again for this week’s series. You should publish a book on this topic!

As I was reading this post my coworker came into my office and made a comment about how fat she is getting. Definitely ironic. You are so right in saying that it has become popluar to make these comments to friends, family and co-workers. Each little comment slowly chips away at our self esteem and we don’t even realize it. Thanks for sharing your personal experience in this blog. It’s very brave of you to put yourself out there like that.

“Just as your diet and life don’t have to be ‘neat’ and perfect and ordered, your relationship with your body does not have to be neat and perfect and ordered. It can be messy, difficult, and complex. It can have ups and downs. It can feel like work.”

I’ve been trying to work on what I think is an important facet of this for me, accepting body and identity both as undefined, accepting fluidity as the strength and comfort it can be, and not as a lack, or a catastrophe waiting to happen. Trying to get comfortable with trusting myself to be without having to be something in particular. And I mean that in a lot of big and small ways.

I don’t mean to downplay the work part of the equation, because it’s important and tough, but the more I can remind myself that I’m capable of engaging with the world (by, indeed, engaging with it), the more peace I find with concepts like “difficult” and “messy.” And “work.” (This all goes right back to fighting the all-or-nothing instinct. It manifests in so many ways.)

And a quick ! for No. 4. “Be mindful of your words.” I’ve found affirmations to be a startlingly invaluable tool. I never would have dreamed it, but it’s true. I had to spend a lot of time–some of it squirm-inducing–crafting them to use language and ideas I honestly believed, but damned if at the end of that, I didn’t have a heap of coping thoughts and a sizable stack of positive things I believed about myself. I was shocked. And it’s a simple, always-available tool that I can use to turn myself away from damaging instincts or escalation.

Gena, thank you so much for this beautiful post. “Body dysmorphia” was not a familiar term to me, but I now have assurance that I am by no means alone in this quest to make peace with my body. Saying or thinking “I look fat” should not be considered normal, yet so many women and men suffer from an ongoing battle to feel happy and confident in their own skin. It’s like I have two voices constantly running through my head. One of them thinks my thighs look big in those jeans or this tank top really cuts into the fat on my back. But the other one tells me how beautiful and healthy and fit I am. And I am. I just have this crazy person screaming right in my face, telling me otherwise 100 times a day, and she can be quite difficult to ignore.

The craziest part is that when I see a friend or stranger who is quite thin, I don’t envy her. I think she looks unhealthy. And when I see a person at yoga class who has a curvy, womanly, strong body, I find that beautiful. Somehow, though, I have trouble making the leap and applying these same standards to my own body. But I am trying, and just writing these words out loud is a form of therapy and mental relief. Luckily, I love food, cooking, and the related culture enough that I’ve never restricted for any extended period, and I can almost always outsmart or out-muscle the evil voice in my head. And with that, I think I’ll go home and make some oatmeal cookies. Thanks again for putting these issues out into the open.

I really love your reminders that body image doesn’t have to be “perfect” in order to be “normal” or at least where it needs to be. It’s a thing that can be hard to remember when you live with a man who every day – without fail – looks in the mirror and thinks he’s a magnificent specimen (for real).

A lot of my body image issues have focused on things about my body shape that I hate. Big legs and hips that can’t fit into most jeans, for example. I’d say it’s only in the last few years that I’ve accepted the shape of my body, and that it’s not going to change. It’s amazing it took me so long, as it’s always been obvious that no matter what I weigh, the shape is the same, even if I can slightly change the appearance through weight lifting. And I’ve finally come to not just accept that the shape is okay, but that it’s part of what makes me, me.

Your description of moments in which you feel beautiful was amazing; I guess I’d never thought of those moments that way. I just think of them as moments that bring me joy, and as such they are moments that I’m not focusing on my appearance because that’s the last thing that matters. But it’s true that in those moments, there is a glimpse of feeling beautiful, even if it’s not the same brand of beauty I once thought I needed.

“Working in hospitals and physician’s offices for the last two years has given me a new appreciation of health, and how precious it is”
I can say I’ve had a similar experience with seeing my parents and aunts and uncles age. Nothing like a good dose of “oldness” to remind ya what it’s really all about. My dad has Parkinson’s disease and seeing him change and struggle with something that will be permanent for the rest of his life is a lesson in gratitude for good health when you have it.

I love your 5 tips. Especially the activities that make you feel good. I had stopped formal exercising for about a year this past year (before I got pregnant and then during) and finally got back into it, and am reminded how much I love yoga and lifting weights, and movement in general. I love the feeling of just being in my body and feeling it’s strength and movement.

This post is filled with such beautiful prose. I truly enjoyed every minute of reading it. It makes me realize how unappreciative I can be of my body at times. Instead of saying how I really need to tone my arms, I should be feeling blessed for even having arms. This isn’t to say it’s wrong to have healthy goals for improving our bodies, but it shouldn’t be so negative all the time. I don’t think I’ve ever heard a girl utter the words “I love my body.” Ever. In my life. It’s no wonder so many of us have body dysmorphia. All we ever hear is body shaming, even from girls who have “perfect” bodies. I remember one time my cousin saying to me, “If anorexic girls still consider themselves fat when they’re really underweight, they must think the average body like mine is obese.” She framed it as more of a question, I wish I could remember exactly how she worded it, but I told her the answer was no, that girls with eating disorders don’t walk around thinking everybody else is fat. At least from my own experience, I never considered the “average” bodies that surrounded me to be anything but normal. It was solely my own body that could never be thin enough. My cousin’s comment really goes to show how our body shaming effects others. We’re not only making OURSELVES feel worse about our bodies by constantly shaming them, we’re causing others (people who don’t even have body dysmorphia) to question their own perfectly attractive bodies. It’s a vicious cycle. Negativity breeds negativity. I love all of your tips, Gena, and I could definitely benefit from making a conscious effort to put them into practice more than I do. Thank you for another thought-provoking and insightful post. This has been a great week of reading.

I don’t think I’d be diagnosed with “body dysmorphia,” because my ambivalence towards my body is not paralyzing and I do experience a great deal of pleasure in my aging body and even, occasional, aesthetic appreciation. I have a very different relationship with my body than I had during my illness, when, unlike many anorectics who continue to hate their bodies and see a fat person in the mirror even as the scale dips below 80, I was quite aware of how thin I was and quite smug and self-satisfied about it. I was strangely healthy during those years, too, running, biking, lifting heavy objects, and moreover, I was never sick, not that I recall anyway. It was only after I gained weight that I started getting nasty winter colds and stomach bugs, etc.

My point is that despite my relatively healthy relationship with my body, there’s no way my recovery could ever be stable if it were based on any kind of body love because as committed as I am to self-care, etc., I’m just not “into” my body the way I was when I was sick. And maybe that’s why, despite being an uber-heatlhy eater, I insist on eating for pleasure first. Because there are days I hate my body, really, but I eat anyway because I love the person who inhabits my body and I’m all about food as spiritual sustenance, if not the primary source of such sustenance. And then there are days I hate the person who inhabits my body, I’m disappointed in her in myriad ways, but I eat anyway because, well, because somewhere along the way I discovered (or rediscovered) that I love to eat.

And so, I’d have to say, the bedrock of my recovery is a transformed relationship with food and not with my body. That may not be the path for people for whom food has taken on too much importance, or for those who are prone to emotional eating, etc. But since my natural tendency is to self-punish, my present inability to restrict my food intake, at least over the long haul, serves me well.

Oh, and I wanted to say too that I’m a big fan of throwing away the skinny jeans. I had a pretty bad relapse in graduate school (not that I was “recovered” before it happened, but I had been inching my way there – I’d gained a bit of weight, I’d gone from eating three planned meals to “three piles a day,” and was definitely eating a wider variety, more spontaneously, and most notably, I was rediscovering pleasure in eating) and of course, in my closet, there were all my skinny clothes, as if I’d known all along I’d be needing them again. I think it’s very very meaningful that when I did finally recover, what’s turned out to be good, I gave all those clothes away. A part of me knew I was burning a bridge and moving on. For better or worse.

Hey Gena, Loved your posts this week as you opened up with your own struggles. I also liked how you mentioned sex. From my background, I have found many people with EDs may have low libido from lowered estrogen so it is nice to highlight the perks of recovery from that front, too!!

Gena, I honestly think this is my very favorite post you’ve ever written. I NEEDED to read this. I honestly couldn’t have said it better myself about how I feel about this disease. I KNOW I will always fight the same fight you do. It’s crazy that someone else’s thoughts are so similar to my own. I’m in the same place you are now with your body, your disorder, acceptance of yourself, appreciation for your body, yet honestly still struggling too. The other day, someone said, “You look great!” and a part of me was grateful, while another part knew they meant I looked healthier from gaining weight the last two years. I know that although I’m still incredibly thin, being underweight sadly always made me feel like I had an edge- a double edged sword that was my safety when nothing else seemed right. It’s so twisted, yet so true. This past week, I’ve taken some major steps with food cravings and letting go of obsessions. The mirror checks are more accepting now, the scale isn’t as important, and my appetite is my guide instead of the measuring cups and teaspoons. It’s so not easy, and I hate bathing suit season as much as the next girl, but this year, I really want things to be different.

Thank you for being so open and honest. I think it makes all of us feel so much less alone, and more like a community going through recovery together. You’re such a beautiful person and yes, you really do look FABULOUS and so beautiful.

So beautifully written, open and thoughtful. I’ve never had the painful relationship with food that so many have but the relationship with my own body has been and is still a struggle so I appreciate the reminder to play nice with myself and be mindful of the difference between reality and my perception. Thanks for sharing!

This was a toughy but you handled it with grace and thoughtfulness. Your advice is simple, yet profound. We should all print your #1-5 and hide it in our everyday bag or tack it to our mirror.
I would add that dysmorphia is an all-consuming preoccupation. It’s an attempt to pin the self down to an acceptable image- but the largest hurdle is obsessiveness and prioritization, not the scewed perception itself. The acceptable image, even for someone who doesn’t struggle with ED, is foisted upon all of us every day through media and the insensitive ways we communicate with one another.
Thanks for this and sorry I missed you while in CA!

Hey Gena – Just wanted to pop in again and congratulate you on your entire series of posts in recognition of ED awareness week. I have to say that this trilogy is your finest, most insightful writing on some really sensitive, hard-to-tackle themes. I can’t thank you enough or admire you more; your bravery and generosity, in the spirit of inspiring others, is so impressive. Having shared a similar history as you, I have been moved to tears as you reveal feelings identical to those I have had and( to some extent) continue to experience. Have fun visiting the West Coast, and safe travels! xo

I appreciate your style, your candor, your willingness to be naked to your audience (the first lesson of a good writer) and your gentleness and sensitivity as only one could have who has struggled themselves with an addiction or disorder.

The feelings of physical imperfection in the BDD mind translates to inadequacies:

“That’s why I have no close friends.”
“That’s why I’m still living paycheck to paycheck since college.”
“That’s why my s/o and I don’t have as much sex.”
“That’s why I’m so afraid my s/o will cheat on me.”
“That’s why I’m so anxious about upcoming social engagements.”
“That’s why I fly into a rage when I’m criticized harshly.”
“That’s why I spend money unwisely.”
“That’s why I can’t get my novel started.”
“That’s why I can’t let my mother’s criticisms slide.”
“That’s why I ….”

Now hear the wheel screech to a halt and the tape flap as it rewinds.

Mama. She was my indoctrinator. Even at 80, she looks at herself in the mirror and tells me how ugly she is. She eats for comfort, is a natural born klepto, and used to tell me that I had legs like a horse (I ran obsessively 10 miles a day in h.s. before my sister asked me if I knew about purging). I tried it and have had it in my tool chest for almost 30 years now.

Triggers are everywhere, even among health conscious vegans who have never had an ED. I started a strictly plant-based vegan lifestyle in November last year. It’s the first time I felt like I found the answer to my obsession with calories, weight, exercise, body fat and guilt. I ate to my heart’s content a variety of fruits, veggies, nuts and seeds and even lost a few pounds! I was shocked, but I had my ear too close to the ground and I started hearing vegans and raw vegans talking about gaining weight, cutting out all the fats and how thin and sculpted they were as a result. They talked about becoming spiritually awakened and sensing things they couldn’t before. I wanted that cleansing, the purity, the simplicity. And I started cutting back what I ate and ignoring my hunger.

The triggers never leave. They’re tied to powerful goals, desires, fears, human needs and unquieted conflicts. And once you’ve conquered your body and seen the scale read 89, 88, 87 – the sweet taste of success and discipline – and you look in the mirror a lot happier but still dissatisfied….it can call again if you let your guard down.

I know myself by now. I no longer promise myself that I’ll never do it again…binge and purge. I’ve only managed to promise myself that it won’t become a regular habit anymore. And I’ve kept that promise since I’ve been vegan. My weight loss goal, however, has still remained irrationally low. That is still my poison, but I know that millions of women are trapped inside a tormented mind of OCD, BDD and ED combined and I thank God that, there but by his grace go I.

PS I can’t pinpoint exactly which part of this post reminded me, but I thought I’d mention that I still recall when, I think at my birthday breakfast at Prasad, you pointed out how often I used to write on my blog about travel/life/dreams in terms of floating/flying/being detached from the ground. You saw the insidiousness of that, where I couldn’t despite my guiding belief that words convey so much of our reality, and it slammed into me and made me rethink things in many ways. I thank you for that, too. For reminding me that we should be firm on the ground, that we *should* make sounds when we walk and leave footprints where we tread. That we should be visible, and solid, and grounded. xo

Bookmarking this forever an always. The whole thing was stunning but my favorite part was the different ways you feel beautiful each day. So much of the work that I want to do is about helping people find this freedom, this self love in sex and I literally cheered when you mentioned it. Yes its one tiny word in one long post and perhaps not even the most important..but it stuck out to me because every moment you mentioned: I’ve experienced and see them as all part of this larger pursuit of pleasure and self-love. Thank you for highlighting this and owning your sensuality in such a public forum. I can see myself referring to this again and again in my work with patients and survivors. ::hug::

Kait, it was just one word, yeah, but what an important word! Discussing sexuality on this blog is obviously new territory for me, but as I know you know, there is plenty of material. My eating disorder radically changed my relationship with intimacy (crowding it out altogether, I’d say), so of course it makes sense that reclaiming sexual pleasure would have been a part of recovery. In my experience, all appetites are interconnected. Disavowing my appetite always resulted in a diminishment of other appetites as well (appetite for sex, for love, for attention, for power).

I’ve noted this in the past, but my ED also made me incredibly controlling and possessive of my body (of course). Part of recovery was learning how to share my body with someone again, to entrust it to another person. Powerful stuff. Thanks for your wonderful comments this week.

Another beautiful, thoughtful and wise post from you on eating disorders that I’ll be adding to my bookmarks so I can re-read. There were so many lines in this that stood out for me and that I could relate to. I also found it really interesting your inclusion of sex as part of self-love and feeling beautiful. At my sickest/skinniest, the last thing I wanted to do was to be intimate with another person. Even though I was achieving my skewed goals of weight loss, I didn’t feel attractive or desirable. I knew I was too skinny, and I didn’t feel feminine. Your inclusion of sex as a way to feel alive and appreciate your body is really spot-on, I think. Eating disorders can rob us of that desire to be intimate with someone else, I think because we’re so uncomfortable with our own bodies, and feeling almost like you’re in someone else’s body, that it seems impossible to ever get to a space where you want to share your body with another person. Thank you for including that perspective, and thank you for these posts – please keep sharing your thoughts on body image and recovery.

Katie, I’m so happy that the post resonated so deeply. I haven’t often talked about intimacy/sex and my recovery, but there’s a lot of rich material there. I, too, shut down that part of myself in the times at which I was struggling most, for all of the reasons you say: disconnect with the body, fear of sharing one’s body with another person, self-loathing, etc.

These posts are so very helpful. I’ve said this before, but I’ll say it again, it makes things that much easier knowing someone who has gone through similar issues and has come out like a rock star on the other side. You are very inspiring.

“But here I am, 31 and, if not always at peace with my body, I am at least committed being in a loving relationship with it.”
I’m struggling through recovery right now myself and look forward to the day that I feel somewhat comfortable in my own skin again. I feel like this day is around the corner.
Thanks Gena <3